Hearing loss after diving: help needed/anything else that can be done?

[chaspope]

Thanks for the details. DCS from snorkeling to 5 meters is so unlikely as to approach impossible. Given that information, it seems likely that you suffered from non-fistulating inner ear barotrauma. Neuropraxia is not an accurate description of that, and hyperbaric oxygen therapy is contraindicated because of the risk for further injury with pressurization. I'm glad things turned out the way they did for you. It's unlikely that hyperbaric oxygen had anything to do with your good outcome.

Under no circumstances should you force a Valsalva maneuver. That is probably what led to your initial injury. A consult with an ENT to discuss options would be a good idea - balloon dilation is one of those options.

Best regards,
DDM

Thanks, I dint feel I really forced it, I guess I just did too many on that day. I saw 4 ENTs who suggested wildly variable treatments, I can share more detail if you are interested but I am not yet allowed direct message

 

[scubaguy532]

Wanted to return to this thread to update with what has happened since my last post.



I started seeing a neurologist at UM who is also a divemaster and has trained Navy divers so understands diving physiology as well. I continued high dose oral steroids for about 2 weeks then went for a follow up hearing test. Showing no visible improvement in the hearing test, remaining almost completely deaf in the right ear, the Dr recommended that I go for a middle ear exploration surgery. Essentially this entailed having time activated steroid injections placed directly into my middle ear so it is closer to the nerve damage that caused the hearing loss. He was confident that doing so could restore at least a significant portion of my hearing.



The surgery and recover following went smoothly, and it has now been over 2 months since the surgery. In the weeks that followed, I could sense an improvement in how much I am able to hear - except for when I am in very loud spaces, I could hear 100% fine with zero issues. However, it turned out that the perfectly fine hearing in my left ear was disguising the poor hearing in my right ear. As when I went for the follow up hearing test 2 weeks ago, my right ear showed no improvement, again. The reason for this was because the volume that I am able to hear in my bad ear has greatly improved since the surgery; however, my word understanding when I have static in my good ear and words playing in my bad ear is still next to zero. I was able to hear the words but unable to make them out.



This was obviously pretty disheartening, especially since I still do not have an exact cause for how this all happened. When the Dr performed the surgery, he discovered a lot of inflamed scar tissue in my bad ear that he removed. Therefore, the leading theory from my doctor is that I had a virus back in November that made its way into my ear, which was already badly inflamed, and the change in pressure during that dive (first dive since the virus) triggered the nerve damage that caused the hearing loss. Obviously, the most concerning thing about this is that there does not seem to be preventing anything like this from happening in my other ear should I return to diving! So, long story short, with the no improvement since the surgery, my doctor does not advise me to continue diving as is, as if something happened to my good ear, I would be practically deaf.



He is now recommending starting the evaluation path for a cochlear implant in my right ear. He is very confident that doing so, about 6 months after the surgery, and at my age (23) could allow me to regain most of my word understanding in my bad ear, and I would be able to dive again, at least having a backup should anything happen to my left ear, which is pretty rare. So sorry for the long story, but that is where I am at right now. I am going for an evaluation for the implant on Wednesday, and will continue on this path as it seems to be my best option not only for diving but to return my hearing to a close to normal state. Would be happy to answer any other questions.

 

[ibj40]

To the OP:

You are lucky (in relative terms) that this is happening at your age.

My hearing loss (also right ear) began as tinnitus that continued to digress as true hearing loss became worse.

None of this was dive related.

This began around age 50 or so.

A hearing test confirmed and an MRI found nothing.

Now at 73, I am fully deaf in my right ear with constant tinnitus.

I wish you luck and success in your pursuit of surgical solutions.

 

[duke dive medicine]

@scubaguy532 wow. Thanks for the update, and I'm sorry to hear about all that.

 

[TheCatFish]

@scubaguy532 Hope you have been doing well. I also experienced deafness in both ears as a result of diving and non-diving activities.

I was also diagnosed with sensorineural loss after a barotrauma incident. I was also given oral steroids without success. I opted to stop treatment after that.
I use a hearing aid these days and did not opt for implantation. Picked up sign language as well. Even more helpful out of the water than in the water. Still diving! Hope you are too.

 

[scubaguy532]

@scubaguy532 Hope you have been doing well. I also experienced deafness in both ears as a result of diving and non-diving activities.

I was also diagnosed with sensorineural loss after a barotrauma incident. I was also given oral steroids without success. I opted to stop treatment after that.
I use a hearing aid these days and did not opt for implantation. Picked up sign language as well. Even more helpful out of the water than in the water. Still diving! Hope you are too.

Wow that helps to know, thanks. I'm sorry to hear though. If you don't mind, would you be able to expand a bit on your situation? So your deafness was caused by barotrauma which I'm turn caused nerve damage in both ears (sensorineural hearing loss)?

I am in a very similar situation right now in which the oral steroid treatment did not work and neither did the middle ear exploration surgery in which my doctor placed direct steroid injections into my middle ear. There has been no improvement in the hearing in my right ear. It seems the most likely cause js damage to the cochlea, otherwise the hearing would have rebounded or responded to the treatment. That is why my doctor is recommending a cochlear implant in one ear.

It is just frustrating because he still will not clear me to dive out of fear that the diving could result in hearing loss to my good ear. He says that if I respond to the cochlear implant I can dive again even with it.

Additionally, may I ask why you opted to end treatment and not go for implants? Was this a decision related to diving?

 

[TheCatFish]

Wow that helps to know, thanks. I'm sorry to hear though. If you don't mind, would you be able to expand a bit on your situation? So your deafness was caused by barotrauma which I'm turn caused nerve damage in both ears (sensorineural hearing loss)?

I am in a very similar situation right now in which the oral steroid treatment did not work and neither did the middle ear exploration surgery in which my doctor placed direct steroid injections into my middle ear. There has been no improvement in the hearing in my right ear. It seems the most likely cause js damage to the cochlea, otherwise the hearing would have rebounded or responded to the treatment. That is why my doctor is recommending a cochlear implant in one ear.

It is just frustrating because he still will not clear me to dive out of fear that the diving could result in hearing loss to my good ear. He says that if I respond to the cochlear implant I can dive again even with it.

Additionally, may I ask why you opted to end treatment and not go for implants? Was this a decision related to diving?

Sure I don't mind:
My deafness seems to have been caused by a combination of prior accoustic trauma (exposure to pneumatic tools and firearms, frequently, from a young age) as well as a scuba diving incident that occured at age 17.
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I was young, dumb, and excited, and I went down to 40 feet without equalizing. My mucous membranes bled into my sinus cavities and "equalized" the chambers. I surfaced and hocked up a large amount of bright red bloody mucous from my sinuses. My eardrums hurt but did not rupture, due to my descent being slow and controlled enough that the sinuses filled with fluid.
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The negative pressure within the sinuses and middle ear seemed to have caused damage to the cochlea. I was treated with steroids unsucessfully. No surgeries since I was unable to afford them and at the time was not DAN insured. Months after the incident, my audiologists tested my cochlea (non surgically using a pressure instrument) and determined that the overall structure seems to be intact but suspects internal damage to the inner membranes of the cochlea, and likely damage to the haircells which stimulate the auditory nerve.
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Diving without proper equalization does pose a risk to hearing damage. Driving improperly also has risks but we still drive every day. I was deemed anatomically capable of equalizing, so when I visisted another audiologist to be screened, they cleared me. Today, I have been down to 140ft and am a sidemount cavern diver, working toward full cave certification and decompression diving (AN/DP) scheduled for this year. I have had no further significant barotraumas and can succesfully equalize.
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Cochlear implantation is a very personal choice. I do not want to skew your thoughts one way or another. I chose not to get an implant because 1) Living with diminished hearing is not causing me distress. 2) Through captioning software and sign language interpreters I have access to public services such as doctors, the court system, education, etc. 3) My hearing aids offer some level of hearing which I enjoy playing with for music and entertainment. 4) Implantation has side effects in some cases that can lead to further complications and discomfort. I have several friends who have implants, some like them, some do not. 5) I am/was a martial artist and mountain biker as well. I take hits to the head sometimes. I didn't want to risk shaving down the bone in my skull to place the internal component of the cochlear implant.

 

[EternalCompression]

Hi everyone, I have been lurking on these forums for a while but this is my first time posting. About 10 days ago I went on 2 boat dives. The first dive I descended to about 80 ft and felt slight pressure as I was on my way down. Not wanting to force anything, I took my time and was eventually able to equalize to the bottom. Immediately after the first dive I noticed fullness and muffled hearing in my right ear. I brushed it off as water trapped in my ear from the hood I was wearing. The second dive was uneventful with no issues equalizing.

A few days later I still had almost *complete* hearing loss in my right ear along with ringing/tinnitus. I called DAN and they assured me it is most likely middle ear barotrauma and will resolve itself with time. I then saw my ENT who gave me a different diagnosis: no fluid trapped in my middle ear as a sign of barotrauma, but instead sensorineural hearing loss as a result of nerve damage in the inner ear. This was not what I was expecting to hear, especially as the pressure I felt on the first descent was not significant enough to concern me. It also surprised me because I never had any dizziness or vertigo which are both listed as main symptoms of trauma to the inner ear/cochlea. Looking back, however, I probably did not equalize early and often enough on that first descent.

Nevertheless, he prescribed me a full dose of oral steroids which I am currently taking and advised that if the hearing does not come back, I should not dive again to avoid risking hearing loss in my other ear. This was obviously a total gut punch to hear and I'm trying not to get depressed about it.

I am seeing another ENT/neurotologist on Friday who is well versed in diving knowledge. I am not sure he will tell me anything different but I am praying there is a path forward both in terms of restoring my hearing in my right ear and being able to dive again. I have read some reports of hyperbaric oxygen therapy as a solution to this issue (Sudden hearing loss causes scare for diver) as well as another poster who experienced a similar issue and got their hearing back after the steroids (Question - Full ear/hearing loss but can equalize fine?). The ENT I saw said that oxygen therapy is a type of fringe medicine used mainly for DCS and would not help in my case.

Has anyone else experienced/heard of complete hearing loss in one ear after diving and know any other possible solutions? From what I have seen/read it is very rare to have a complete loss of hearing, rather than partial hearing loss associated with barotrauma. The thought of never diving again is one that I could barely fathom to imagine and I'm praying there will be a positive outcome to this situation. Thanks.w

We us hyperbaric therapy regularly for Sudden sensorineural hearing loss (SSNHL) and vestibular DCS as well..... I work up at ST Lukes Hospital out of Milwaukee, call up and talk to one of our providers. 414-385-2846

 

[chaspope]

Hi Eternal, reading these forums and with my experience seeing various ENT recently it seems there is a divide of opinions as to weather or not Hyperbaric Oxygenation helps with sensorineural hearing loss!

I had it after a no fistula IEBT, and was told by several doctors not to have barochamber or that, if I'd had it, it must have had no positive effect. Conversely I was told by another lot of doctors/professor to go have it a.s.a.p (which I did) and that I should maybe have another session in a few months (which I did not).

As a provider of this kind of treatment - what would you say - does it help? Are there any proper studies?

The barochamber I went to was also treating folks with covid induced hearing loss, incl babies. I started 3 days after my hearing had just began to recover - up from from complete 0. I was told it would have a great effect, but it didn't feel any great difference during the course of 12 days. A month later another ENT told me I'd had an amazing recovery (from 0). My hearing stopped improving and has since remained at the same (no trebble) state.

 

[scubaguy532]

We us hyperbaric therapy regularly for Sudden sensorineural hearing loss (SSNHL) and vestibular DCS as well..... I work up at ST Lukes Hospital out of Milwaukee, call up and talk to one of our providers. 414-385-2846

Yes, I was told this as well...but I was also told that after a few months, it is no longer effective unfortunately.